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Monthly Archives: December 2013

Postoperative pain and recovery time are major concerns for any patient undergoing surgery. I think this may be even more of a concern with cosmetic surgery patients, because getting time off work can be tough. Today we’re going to talk about breast augmentation recovery, including what type of pain you can expect, what your doctor may offer in terms of pain control, and how long you may need off work afterward.

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Every person responds to pain differently, of course, so I can only speak in generalizations. But breast augmentation is often less painful than patients expect. When you meet with a Plastic Surgeon to discuss breast augmentation, ask him or her what medications will be prescribed for pain. Many physicians will prescribe a narcotic pain medication. Some will also prescribe a muscle relaxant as well, especially if the implant is placed under the pectoral muscle. In addition to medications, my patients can also request a pain pump- a tiny catheter which diffuses local anesthetic into the surgical site for the first three days, significantly reducing pain. Also, be aware that larger implants generally are more painful than smaller implants, because they are stretching the overlying tissue more.

How long you need to be off work really depends on the type of work you do. If your job does not involve any heavy lifting, you may be able to return to work after several days to a week. I do limit lifting for the first month, however, because it increases the risk of bleeding and developing a hematoma (a collection of blood) at the surgical site. Even with these limitations, however, it is important to continue moving your arms and stretching your upper body after surgery to decrease pain and stiffness. Your surgeon may give you several stretching exercises to start the day of surgery.

Here are some questions to keep in mind and discuss with your surgeon regarding your recovery from breast augmentation:

Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

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I’ve avoided talking about the Affordable Care Act until now, because I like to keep this blog relatively free of politics. Of course, with all the changes occurring in health care, it’s virtually impossible to avoid discussing it altogether.

I am going to avoid sharing my opinion, and that in part is because I’m not entirely sure what my opinion is. Like everything in life, the ACA has both good and bad parts. But today I want to bring up one facet of the Health Care Exchange that you might not be aware of- whether your provider is in-network. Please be advised, my knowledge of this is only based on 1) my personal experience with the health care exchange (e.g. healthcare.gov) and 2) what is going on here in Cleveland.

With that in mind, here is my word of warning to you, the consumer. If you sign up for coverage through the Healthcare Marketplace, and you already have a physician or hospital system that you like, check to see if that provider is on your new insurance plan. I would recommend looking at included providers through the healthcare.gov website. I myself searched for some plans out of curiosity, and to see how well the site was working. When the website gives you a list of plans, there is a link on each plan so you can search for providers or hospital systems. The process is a bit tedious, as it links to the external insurance company website, and you have to search each plan individually. But you absolutely need to do this.
Why can’t you just call your doctor’s office and ask if they take your insurance? Well let me give you an example. Here in Cleveland, CareSource is a fairly popular insurance plan. Many physicians and hospitals in the city take CareSource, including my office. But if you purchase CareSource through the health care Marketplace, the providers who are in network are very limited. As in, you have a choice of exactly one hospital. If you purchase CareSource through the Marketplace, you are only covered at MetroHealth. CareSource, purchased through the Marketplace, elected not to negotiate contracts with any other hospital systems (e.g. the Cleveland Clinic, University Hospitals, or Lake Health). Thus my office, who participates with insurance companies that negotiate contracts through our PHO (physician hospital organization), cannot take that type of insurance. But we do take regular CareSource. So if you call our office and ask if we take CareSource, the answer is yes. But we may not take your CareSource.

So my closing recommendation? If you purchase insurance through the Marketplace, check through the Marketplace to see if your provider is in-network. Do not just call your provider to see if they take your insurance plan, because they may not realize plans are different if you purchase insurance through the exchange.

Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

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On the surface, acne seems like a relatively simple problem. So why do I recommend to people that they see a physician for acne?

I see many patients with acne, and there are definite benefits to consulting a physician who treats acne, such as a Dermatologist or Plastic Surgeon. Acne is not only socially detrimental, but cystic acne can cause permanent scarring. Laser treatments can improve the appearance of acne scars, but the best treatment is definitely prevention. So where should you start?

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First and foremost, make sure you are using the correct skin care regimen, as many patients with acne don’t use the right skin care, or don’t use it correctly. For example, I find many people with oily skin don’t like to use moisturizer because they feel it makes their skin oilier. But the reverse is actually true; keeping your skin well-moisturized signals it to produce less oil.

Second, there are prescription medications that are very effective for treating acne, but these are only available if you see a physician. These may include Retin-A and benzoyl peroxide, or a combination medication such as Epi-Duo.

Finally, additional options such as laser therapy and chemical peels may be appropriate for acne that has been resistant to treatment. Laser treatments work by killing the bacteria associated with acne, and may help decrease oil production. Chemical peels can help unclog pores and may decrease the frequency and severity of breakouts.

So long story short, if you suffer from frequent acne breakouts, I do recommend seeing a Dermatologist or a Plastic Surgeon for an evaluation. Although some of the treatment options are not covered by insurance, this initial visit generally is covered.

Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.